Skip to main content

Full text of "Adolescent mother and her infant : correlates of transaction and development"

See other formats


CORRELATES OF TRANSACTION 



DISSERTATION PRESENTED TO TOE GRADUATE COIBCIt 
OF TOE UNIVERSITY OF FLORIDA IN 
PARTIAL FULFILLMENT OF THE REQUIREMENTS 
FOR THE DEGREE OF DOCTOR OF FHILOSOPHY 



SHIVERS IT 



FLORIDA 



Copyright 



This work is lovingly dedicated to my family 

for enduring my nevor-ending adolescence 

and most especially, for teaching me 

the true meaning of attachment and bonding , . . 



ACKNOWLEDGEMENTS 



of individuals who hav 
special appreciation f 



rso of ray doctoral wOrl 






Marci Hall of the Department of obstetrics and Gynecology 

n of Neonatology, Department of Pediatrics. These indivi- 
a great deal of sensitivity to this study of mothers and 

hectic schedules. It is with heartfelt thanks that appreciation is 

tudo for his gentle direction and thoughtful guidance. My thanks, too, 
for his patience in teaching me to reason with feeling and feel with 

To Dr. Michael Resnick, a special thanks for opening up a whole 
new world and allowing me tc dream dreams and make them come true. 

I am appreciative, as well, for being given the freedom to erplore. 

It is for all of his creative idealism that 1 am especially grateful. 



Francis Graves Becky Montevideo 







IF CONTENTS - 




using the Adapted Beckwith Behavior Scale . Demographic and socioenviron- 
oental data were obtained from the Child and Family Development Interview . 

In order to roduco the number of variables and define the more 
global dimensions of mother-infant transaction, a correlation matrix 
of the 27 variables of the Adapted Beckwith Scale was subjected to a 
principle components analysis. As a result of this analysis, five 
dimensions of mother-infant transaction were defined and each subject's 
composite score was calculated for each of the five rotated components. 



early pregnancy and parenting. These meat 
mother's age and education, baby's sex ant 



e regressed on 



if prenatal care received by the mother. 

:e analyses indicated that the age of the 
mother and the absence of prenatal complications had a positive 
relationship with the infant's mental development. The plots of the 
residuals evidenced no deviation from linearity. It was concluded 
that there was a positive linear relationship between these variables 
and the infant's mental development. The type of prenatal care 
received by the mother contributed to the prediction of the infant's 
mental development. The follow-up pairwise comparisons of each type 
of prenatal care indicated significantly higher means for infants whose 
mothers received Teenage Pregnancy Team care (comprehensive services) 
when compared to those groups receiving care from a private physician 



and Shands Teaching Hospital High Risk Clinic (obstetric caro only) . 
The data did not cuppoKt the hypothetic that mothea-iniant inanoaction 
i wUed ai a function Ofi the aye oi the mothe/i. 

die infant, a second multivariate 
is implemented. The dimensions of 

lich contributed a uniquely significant 



mltiple regression analysis wi 









h were identified 






is predictors of mental development 
s mother; 2) the type of prenatal care received 

jund to vary as a function of: 1) responsive 

liffered, on the average, by 2.6 points on the Mental Development Index 
ind by 1.2 points on the Psychomotor Development Index. 

The results of this study suggest that the infants of young 

'rom early intervention of forts. The data also supported tho idea that 
:he mother-infant relationship is important to the infant's development 
rf conference. Sesed upon the findings presented in this study, wo 

lode 1 5 of prenatal, perinatal and pediatric support at 



with enhanced development of the infant. These findings suggest 
interventions for the young parent fondly in order to enrich the 



INTRODUCTION 






irious concent by professionals attempting tc 



there exist servers! studies which explore the various aspects of early 
pregnancy and parenting, very little is known about the nature of the 
relationship between the adolescent nother and her infant and the 

What are the characteristics of the very young Bother -- how 

How does she relate to her baby and what are the effects of her style 
of Bothering on her baby and the developing faieily unit! Answers 
to those questions pose a challenge to the researcher and are in need 

study attempts to explore the role o! 

relationship between infant development and mother-infant transaction 

study will assist professionals by increasing their understanding of the 
developmental status of the infant and tho parenting style of the young 
aother in ordor to design Bore comprehensive programs for the young faaiiy. 



standing of the adolescent undertaking the tasks of early parenthood. 
It is through this understanding that our interdisciplinary efforts 
may become more sensitive to the complex needs of the young mother, 
her infant and her family. The commitment to quality care implies 
a change on the pare of the professional community- -a change based on 
estpirical evidence which documents the educational and developmental 

on the strengths within the family, our efforts will project a more 
supportive quality. It is this belief in the positive cfc 
of young parents --courage, enthusiasm, adaptability and, t 







families remains a challenging question. 

stances, are commonly viewed as a transitional period— one in which the 
individual is attempting to establish equilibrium and adjust to the 
responsibilities of becoming a parent; of caring for another human 



life [Rossi, 1968 ; Packer, Resnick, Wilson and Resnick, 1979). This 



extremely stressful period 



:o parenthood on the individuals 
involved os it related to ftiture parent-child transaction has been the 
subject of many current studies, Bratelton's (1973) findings suggest 

beginning of attachment to the infant. The stages include: 1) plan- 

pregnancy: 4) acknowledgement of fetal movement; S) acceptance of the 
fetus as an individual; 6) birth; 7) seeing the baby; 8) touching the 
.by. Russell's (1974) examination of 

is situation which involves a reorga- 

:o be "bothersome" to new parents. Relevant 
id by Russell from self-report checklists were: 
cation which affected the planning of the birth 
:o marriage; 2 ) a high degree of commitment to 
the parenting role; 3) good maternal health; 4) 8 nonproblematic baby; 
and 5) preparation for parenthood. These factors are compounded in 
magnitude in the developmental tasks of the adolescent mother. 

Of special concern for the very young mother is her ability to cope 
with the multidimensional aspects of parenthood and to facilitate positive 
transactions with her child. The five factors discussed above suggest 

concept of self; and 2 ) the parent's role transition from an individual 



transition to parenthood ii 

relationships was noted t 
adaptations! factors note 

and a positive adjustment te 



ir baby becomes potentially more 



devastating. 



and its implications for 



icern is the lifestyle chosen by the mother 
le development of the mother, her baby and the 
in by the mothers have included 



family, relatives or friends. The ramifications of the choice of llfe- 

"burdens and benefits" of early parenting (Furstenberg, 1978). Negative 

skills; 2 ) family impoverishment due to the high incidence of repeated 

divorce rate for pregnant adolescents who marry; 4) a higher degree of 

mother's lacking in prenatal care (Placet and Jones, 1976); and S) a 
lack of preparation for the parenting role (Crider, 1976; Badger et al., 
1974) resulting in a lack of skills in facilitating parent-child relation- 
ships, as well as a high degree of suspected child abuse (DeLissovoy, 1973). 

a difficult to assess and 
:e staggering thar 



of young mothers and more perplexing thar 
prevalent attitudes of today's society. 






perspective 



re Concept of Parent-Cl 






capabilities. 



sequentially integrated systems of readiness (Gordon, 1975). The ability 
and which forms the base upon which future development and learning grow. 



individuals wi 



father and other family membc 
the attachment of or 

and videotaped 

patterns and behavioral components in the observations have indicated 

language, cognitive, and socioemotional growth (Clark-Stewart, 1975), 
These variables include affective warmth, face-to-face orientation. 

It is these attributes which are the focal point of this study. Of 
special interest is the relationship between the mother’s ability to 
interact in a manner which is responsive to the needs and capabilities 



tde and a relationship 
bonding experiences— those whic! 

tonne! 1, 1976; Lamb, 1977). The 



s ability to perticipi 



In summary, the research indicates that the infant is a competent 

tasks, and must depend on other individuals for life sustaining and 

the child's first three years of life (Gordon, 1975). What ivcaini in 
question ii tho quality o$ out pwvidzd by Hit vetiy young mothm. 

and the infant's development will thus contribute toward a more thorough 
understanding of their needs and will make it .possible to design moro 






r investigation it 



order, perinatal risk status, socio-economic status, social support 
system, ethnicity and participation in prenatal treatment and childbirth 

the independent and dependent measures of infant development and mother- 
• investigated by an overall test of no 



specific variables under investigation indicated the degree tc 
they contributed to the prediction of developmental outcomes. 



1) Do Infant development and mother-infant transaction vary as 
a function of the age of the mother? 

2) Is the relationship between the mother's age and each dimension 

for all ocher independent variables? 

3) What is the nature of the relationship between prenatal medical 
care and development at six months after controlling for ail 

4J Which variables contribute predictive information to the 
identification of developmental delays on infant development 
measures at six months? 

5) Is there a positive relationship between the extent of prenatal 
and postpartum parenting education and infant development 

mother's social support system and transaction and the inf ant ' 5 

infant's development. Wo have reason to believe chat the young mother 

sources of information are limited in number and yield inconclusive 
findings. This study was designed to explore the ui 



of socioenvironmental , nedical and educational variables in order tc 



our interdisciplinary efforts to provide coiaprehen- 



RESEARCH 




As noted previously, the adolescont undertaking the task of 
motherhood faces both a transition fTom her family of origin to 
psychological independence and the transition to the responsibilities 
of parenthood. Her relationship with hor baby and her baby's growth 
car. be viewed as a function of the mother's ability to establish 



i this chapter has therefore been selected from 
1) the study of parent -ii 
it development ; and 2) the 



adolescent parenting. 



with their infants is limited by the fact that there exists but one 
age-specific studies of the mother-infant relationship and transaction 








i birth; 7) seeing the baby; 8) touching the baby; and 9) giving 
ire to the baby. 

In view of the findings by Zelnick and Kantnor (1973) regarding 
io large number of unplanned births to adolescent women, the subse- 
•f feelings of attachment to the infant remains 



the relationship between 

it relationship and 
social learning and 



in question. This is confounded by the 

These factors pose additional threats tc 
the adolescent mother and her infant. T 

to their impact on the adolescent mother- inf; 
are in need of further ex? 1 oration . 

When considered within the framework o: 
experiences, the feelings brought by t: 

mont, the effects of imitation and modeling, cultural influences, 
values and expectations (Klaus and Kennell, 197S). The role of the 

an important area studied with respect to early pregnancy and parenting. 
Fox (197S) notes the family's multifaceted impact on the adolescent as 

styles and by the quality of the relationships between dyads within 
the family and among family members. 

In studies of maternal-infant attachment, Ainsworth (1972) 
has examined the qualitative characteristics of interaction from the 
study of separation and has offered some defining al 



attachment as a phenomenon. This attachment is viewed as an environ- 
mental adaptation evolving from the infant’s attempt to gain proximity 
to the primary caretaher. Attachment differs from dependency in that 
it involves an affective preference for contact or multisensory 
stimulation, as opposed to the desire for the fulfillment of a physical 

the establishment of eye contact with the mother. Observations have 
shown that gating is followed by locomotor approach, lamb (1974) 

related components of behaviors which are uniquely individual expressions 
and must be viewed as a part of a sequence in the transactional process. 
Behaviors are then clustered to find measurable criteria without 
threatening attachment as a concept. 

In an attempt to categorise structural patterns and behavioral 
components and to quantify optimal maternal behavioral variables, 
several studies have focused attention on direct and videotaped observa- 
tions of dyadic interaction. Bratelton et ml. (197S) stated chat 
"it is through an early system of affective interaction that the develop- 

individuals will be fueled" (p.80). The study examined twelve pairs 
of mothers and infants involved in face-to-face interaction over a twelve 
month interval. Behaviors such as vocalisation, head position, 
direction of gaze, body position, amount of movement and handling 
revealed that the quality of each partner's actions were in direct 
relationship to the other. The behaviors wore viewed as an indication 
of intentional affectivlty and indicated that each 






s.tsr;™ 



The effects of the quality of mother-infant interaction 



idy of 369 eighteen month olds in repeated 

le infant and 'a dependence upon 
its nurturance through reciprocal transactions (Clarke-Stewart, 1973). 
Findings indicated a significant relationship between maternal stimulation, 
responsiveness, and expression of affection and the child's developmental 
changes and social, esiocional, cognitive, and language competence. 

The most influential factor was found to be tho quality, rather than 
nonresponsive quantity, of verbal stimulation. Other important factors 
included the mother's role as an environmental mediator, her expression 
of positive emotion, and frequency of responsiveness, stimulation, or 

data suggested that responsiveness to the infant's behavior had a duel 
effect as it not only reinforce*! specific behavior, "but created an 
expectancy of control within the infant which generalized to new 
situations and unfamiliar people" (Clarke-Stewart, 1973, p. 107). Other 
studies indicated maternal involvement with the neonate immediately 
after birth as having positive effects on the mother's psychological 
state and thus her ability to reciprocate responsively (Powell, 1974,- 
Klaus, Kennelland Krause, 197S) . 

the father necessitates. a..brief discussion of current -St: 



plorcd the importance of the father's role and his transaction with 
the infant. By means of a self-report questionnaire and interviews, Viente 
Crockenberg (1976), examined the nature of the transition to fatherhood 
with respect to the husband-wife relationship and the effect of Lamaze 









preparation £o 

high correlation between the husband-wife 
meat to perceived changes, medical preparation 
insignificant in facilitating adjustment after birth. Khat appeared 
meaningful in the transition from dyad to triad was the sense of 
"family" established as a result of the father's participation in the 
birth. Total adjustment was found to correlate negatively with the disruption 

wife, and a discrepancy between the father's expected and actual care- 
taking role due to breast feeding. This aspect of early marriage and 
fatherhood has bean virtually ignored with respect to early paronting 
(Chilman, 1979). 

Studies of fathers* involvement have supported the importance of 
the father- infant transactional relationship. Parke. and Sawin's 
(1976) observations of fathers, both with the mother and alone with 
the neonate, indicated that the fathers were equally involved in 
establishing eye contact, holding, vocalising and touching the infant. 

Fathers were also successful in caretaking routines, and often exceeded 
the mother's participation. In the context of feeding and on other 

able to interpret infant behavior and modify their own behavior in 
response. It was also noted that fathers touched and vocalized to 
first-born males more often than to other offspring. Longitudinal 

infants at six months (Parke at 






laboratory 



competence (Lamb, 1976b) . During unstructured free-play in a 

the effects of each parent on the transaction process involving 
the other parent. The effect of a stranger's presence (a stressful 
situation) was also investigated in this study. The findings indicated 
a significant reciprocal effect in the presence of both parents on 
both mother-infant and father-infant relationships. The infant's 
affiliation behaviors — stilling, reaching and touching — and 
interaction during play showed a preference for the father. In a 
stressful situation, however, primary attachment surfaced and infants 
undor two years of age sought proximity to the mother. Lamb (1976) 
points out that the results of his two studies should not be used to 
equate affiliation with attachment as an affective preference for 



The findings that early interpersonal t: 
importance to the young child's development o: 
further investigation into the expanding socialization process. 

parent-child relationship was shown to be related to the language, 
were followed from nine to eighteen months of age (Clarke-Stewart, 












1972; Bell, 1974; Bratelton et al., 1975; Klaus and Kennoll, 1975). 
The parent's distinctive interpretations of the infant's states of 
arousal have been shown to prompt an appropriate response to stimula- 
tion. The extent to which the behaviors of significant others can be 
anticipated from contextual events functions as a determinant of the 
quality and extent of the infant's responsive reaction [Goldberg, 
1977). The ability of the young mother to interpret the state of her 



number of authors (Hardy et al . . 
Beckwith et al. (1976) studi 



on sonsorimotor 
Beckwith's 



developmental quo; 



DeLissovoy, 1973) and 
pretorm infants’ inter- 






variables which woi 






:c qualitative interpersonal skills and note 



reciprocity. From initial attachment 
n evoking a response and, as a result, - 



of mothers ai 



(Bell, 1974; Brazelton et ai., 197S). 

In looking at the quality of 

action indicates the mother's capability to adapt her language behavior 

the mode, length and complexity of mothers’ responsive language and the 
child's developmental level. This suggests that the young children’s 

findings further illustrate this concept of social learning in verbal 

from within his cognitive repertoire” (p. 341 . The nonverbal aspect of 
interpersonal communication between five year olds and their mothers was 
explored by Schmidt and tore (1970). Thoy noted a difference between 
sopntaneous signals not intended as communication and expressive 
behavior transformed by the intention to communicate. Their findings show 



higher socioeconomic status. No significant differences in body contact 
or closeness were found to be associated with socioeconomic status* 
Emotional implications of the verbal and nonverbal environment 
were the subject of investigations done in sequential semi -structured 
observations of one and two year olds in middle class homes (Nelson, 
1973). It was found that nondirective parental strategies which were 
accepting of the child’s behavior, Including feedback 






responding, were significant in the facilitation of emotional and 
language development. Behavioral evidonce which supports the effects 
of encouragement and reflective responsiveness was seen in laboratory 
observations of mother-child transaction as facilitating attention control, 
spatial orientation and field-independent cognitive styles (Bronson, 

1972; Campbell, 1975). In studies relating infancy to early childhood, 

the level of expressiveness and abstractness and wasdevelopmentally 






to differentiate the "perspective reality orien- 
through increasing empathy and decxesing egocentri- 
!his suggested that from early transactions, 

:o learn how to affect another individual. Through 



city (Neuman, 1976) 

this process, the infant (and young child) learns as i 
response of another is on expression of feelings and : 
these expressions are directly related to the process 



In summary, the development of the child appears to be strongly 
associated with the quality of the relationship between mother and 
infant. These studies which have dealt with the concept of transaction 
clearly demonstrate that the mother-infant relationship Is of prime 
importance to the development of the child. Still, surprisingly little 

of information have been limited in generalisability. They do, however, 
acknowledge the need for concern regarding the psychosocial, educational and 



arly childbearing. 



consideration of the very young mother in future research will extend 
our knowledge base. Exploratory studies of the young parent family will thus 
strengthen efforts to iuqirove the quality of professional services to 
the family as a unit and enhance the quality of life for each individual. 



wmsm&=- 



of generalization about the parenting style of adolescents are made 
without regard to the design of the given study. For examplo, many 
authors described negative behaviors of the adolescent parents 
(Detissovoy, 1973; Prosser, 1974), but the sailing was such that only 
adolescents were included. If one is to suggest that young nothers 
display a higher incidence of dysparenting, it is necessary to include 
the "of age" mother in the design. Without this inclusion, we are 

style of parenting. A similar constraint is placed on generalization 
from studies of the infants of adolescent mothers. For this reason 
limitations will be noted in early research concerning the young mother 



bearing 



er to better understand the consequences of early child- 
the mother and her infant it Is necessary to con$arc the 
r to her "of age" peer. Variables of interest include the 



of the infants of adolescents. This review will therefore 
se issues from the perspective of their relationship to 



The Etiology of Early Pregnancy 

In looking realistically at newer research on adolescent parenting, 
it is evident that there are two distinct categories. One is the study 
of pregnant teenagers and the second is the study of teenage mothers. 

In other words, fhene in a iCiik-dig dt^enen ce b&Oeeen becoming a 
ptegnnnf teenage* and beaming a -teenage met/iet. This issue is 
concerned with tho element of choice iroon the confirmation of pregnancy. 
The individual often is able to choose whether to: 1) abort or 
continue the pregnancy; and 2) give the baby up for adoption or under- 
take tho tasks of parenthood. 



Several disciplines have taken issue with the phenomenal number 
of pregnancies which have occurcd during adolescence. The biomedical 
explanation of how and why pregnancy occurs is quite well known and 
involves the science of human reproduction. From the political, socio- 
logical and educational perspective we find that a large number of early 
pregnancies are also due to young people's lack of knowledge or misin- 
formation about contraception and a lack of confidential family planning 
services made available to them (Klein, 1978; McKendry et al., 1979). 

The psychological and psychosocial antecedents of early pregnancy 
are more intricate since we are concerned here with the dimensions of 
human sexuality. From this standpoint, early sexual activity and 
resultant pregnancy become more comprehensible. 

Paulker's (1970) data from a study of girls who became pregnant 
out of wedlock suggests that "the girls are not pregnant because they 
are different, but are somewhat different because they are pregnant" 

(p. 163) . Rossi (1968) interpreted this concept in her discussion of 
the transition to parenthood and its direct relationship to the intent 
of the individuals involved. Rossi stated, "the inception of a pregnancy 
... is not always a voluntary decision, for it may be the unintended 
consequence of a sexual act that was recreative in intent rather than 
procreative" (p. 31). 

The question of intent has been explored by Zelnik and Kantner 
(1978) in their 1971 and 1976 studies of first pregnancies of women 



national Probability Survey statistics, revealed that there has been 
little change in the proportion of white teens who become sexually active 
and pregnant each year, but there has been a substantial decline in the 



number who delivered. The authors 



pregnane do so intentionally, but fen who become pregnant use contracep- 
tion" (p. 11). The black population evidenced little change in the 
number of first pregnancies and an eight percent decline in premarital 
intercourse. The authors stated that a discrepancy existed in the number 
of live births and abortions reported by Blacks which was possibly 



wore noted to report a higher number of live births and fewer abortions 
than were actually counted in the National Survey. It is important 

naires and interviews is that which the subject is willing to disclose. 
This limitation is especially relevant to this study due to the oxtremelv 
personal nature of the questions regarding intent. Regardless of 
the intent, we ore faced with the fact that one million adolescents 
become pregnant each year (Alan Guttmacher Institute, 1976) . 

Turning to the study of adolescent psychology (or psychopathology, 
as it may seem), several conflicting studies focus on the personality 
of the adolescent as an explanation of her sexual behavior. A comoosite 
personality profile of the pregnant adolescent is one of a young woman 
who typically came from a broken home, was sexually active with one 
partner on a steady basis, reached an early menarche, was soxually 
impulsive, narcissistic, sociopathic, rejected, isolated, lonely, 
unsuspecting, and/or unprepared (Kane and Luchenbrugh, 1973; Rosen, 

1661; Cobiiner et al., 1973; Barglow et ol., 1967; Malmquist, 1967; 
Claman, 1969; Gottschalk, 1964) . Another view is that "adolescent 



characterised by a methodological problem in either the use of small 



U disgrace, and the stress of financial burden are feelings which 
shared among all families of pregnant adolescents, regardless 
il origins. The family's reaction to the pregnancy 
'e important to the adolescent's development as a mother. 

As has been noted frequently throughout this work, we are concerned 
here with the special ways in which mothers and their infants 
establish a relationship and grow togethor. The study of early 
parenting involves a unique set of characteristics and stages through 



le decision regarding 






The study of this phase in the 
synthesised by the three authors v 
perspectives of developmental and 

daughter relationship has per! 
the pregnancy is resolved. 

Furstenberg (1976) has d: 
of the daughter's pregnancy 01 



Tne works of Chi Iman (1979) , Furstenberg 



md especially tl 









acknowledgement of the daughters sexuality. The reaction was o 
shock and disappointment. This contradicts the often hold beli 
that early pregnancy and illigitimacy is an acceptable trend an. 
lower socioeconomic and/or minority cultures. Prosser (197S) 



complemented this with her finding that there was an association betw 
early maternal childbearing and the behavior of the daughter. 

Chilman (1979) cited the fact that "daughters whose mothers had 
early pregnancies were more likely to become pregnant as teenagers". 
As found in her earlier work, "actual maternal behavior is apt to be 



more influential tl 
outcomes of] chil. 



id attitudes ar 



The influence of the family of origin on the 
pregnancy and the use of contraception and abortio 
n general, the authors hove co 

le degree of connectedness i 



area of interest, 
girl's decisions both to bee 
are related to her parent's 



(Jessor and Jesse 
(1977) finding th 



lor, her relationship 
cited the Rosen 






Hie plans implemented by the young mothor following the 
decision to continue the pregnancy wero discussed by Young, Birkman 

who carried their pregnancies to term, the mother was noted to be 
especially influential in the decision making process. The daughters 
living arrangements, educational plans and child care and childrearing 
arrangements wore those most often influenced by the mothor. 

We can look to the .national Center for Health Statistics for a 
quantitative summary of those who gave birth during adolescence in 
order to understand the trends. In comparing the birth rate of 




illegitimacy rates in the young reflect changes in the white population. 
The birth rate for black teenagers has declined steadily and the 
illigitimacy rate is fairly stable [Baldwin, 1978)." 



snt survey from the final 1977 National Natality 
iled a surprising trend in the fertility rate of those 
le age of 18. The fertility rate "declined slightly 



Planning Persoect: 






encouraging, tho fact remains that one of every five babfes born 
today is bom to an adolescent mother (Baldwin, 1978) . 

The rate of child bearing and its relationship to childrearing 

1971, of those adolescents who gave birth out-of-wedlock, 87 percent 

members or friends, and 8 percent gave the baby up for adoption. 

This large percentage of infants raised by very young parents has 
led to the study of the mother's ability to care for her baby and the 
consequences of early parenting on the baby's development. 



The Transactional Relationship Between the Vqtv Young Me 
relationship is characterized by seric 



s shortcomings. We are presented 



1) tl 



le transactional procei 
unstudied; 2) there is an extremely high d< 
the research related to adolescent caregiving; a 



las been virtually 

comparison to the "of age" mother has been made. Our discussion of 
the adolescent mother-infant relationship is thus limited. It is 
to this specific gap in our knowledge that the present study was direct 

address the questions regarding the behavioral repertoire of the 
young mother. - An important aspect of early parenting has been 
the developmental tasks of adoloscence which bear heavily on the 
transition to' motherhood. Fox (197S) summarized the importance of 
several tasks related to parenting which were: 11 resolving feelings 

2) an intense need for closeness and concurrent feelings of being 

defining one's self; and 4} the establishment of appropriate attach- 
ments apart from the family. As has been stressed before, these are 
often overwhelming and have been noted to influence the young mother's 
relationship with her child. — - 



In a study of adolescent's expectations and attitudes towards 
their infants, Debissovoy (1973) found disturbing choractristics of 

tient, insensitive, irritable and prone to uso physical punishment 



with thoir children” (p. 22). DeLlssovoy also found young parents to 
have a lack of knowledge about child development and unrealistic 
expectations of the infant. It was suggested that this lack of 
knowledge governed the parents' actions to the child and constituted 
a form of emotional abuse. These findings were based upon interviews 



conducted during five visits in the homes of 48 adoioscont families 
residing in semirural Pennsylvania. The results prompt a caution 



a comparison g: 



regarding their generaliiability due to l 
of urban or adult parents (Crider, 1976). 

The conslusions reached regarding yc 

perspective of its relationship to her ir 

found that almost half of all mothers bet 

they had anticipated” (p. 15). The authc 

mother. Klein (1978) supported this noti 
been "less than adequate as nurturing mothers" (p. 1154), and concluded 
tnat the lock of knowledge and preparation for parenthood suggested a 
need for more appropriate interventions. 

Epstein (1979) addressed the lack of knowledge about infant develop- 
ment and its implications for mothering. On prenatal and six months 
postnatal assessments of 125 mothers in the High Scope Project, teens 
evidenced a lack of knowledge about the infants' cognitive and socio- 
emotional development. The author noted that "babies were seen as 



ire indepth investigation 
s development as a 



(Hiring little more than basic caregiving" (p. 64). 

because young mothers are unrealistic about what they need to givo, they 
"aro likely to miss the gratifications able to be received from a baby" 

(p. 64). The results of this study provide valuable information regarding 
the educational needs of young mothers. Again, we are unable to ascertain 
whether or not this lack of knowledge is attributed to youth due to the 

Tho findings regarding the problematic mothering style of the 
young mother have led to the often unwarranted conclusion that 
adolescents are likely to abuse and neglect their children to a 
significantly greater extent than the "of age” mother. Epstein [1S79) 
contrasts her findings of expecting "too little, too late" with the child 
abuse literature regarding abuser’s expectations of "too much, too soon." 

found the infant's birthwoight. not the age of the parent, to be signifi- 
cantly related to abuse. 

Kotelchuck's (1979) most recent investigation into the prediction 
of pediatric social illness has illuminated the relative importance 
of the mother's age in predicting child abuse and dysparenting . His 
findings from a study in Boston revealed the parent's social isolation 

ing. In a discriminant analysis which accounted for 40 percent of the 
variance among abusers and nonabusers, the author found all measures 
of depression and isolation to be significant. Xo significant relation- 






Extending this concept of the parent's social support system to 
il study of mothers and their newborns, Bratelton and 



. South. Their findings revealed the supportivo 
td family to be strongly related to both mother- 
id the behavioral a; 

Perhaps the most in-depth st 
extended family to the adolescent mother-infant relationship are 
those of Furstenberg (1976; Furstenberg and Crawford, 1973). His 
longitidunal studios showed that most adolescent mothers were "apparew 
ly loving, responsible, effective parents" (Chilman, 1979, p. 261} of 
young children, especially if the responsibilities of child care 
were shared by another adult. 

the early years of parenthood and its relationship to longitudinal 

year follow-up of a sample of 404 Baltimore families, no differences 

interaction were noted among families of differing residential careers 
or childcare arrangements. Among those mothers living alone or 
apart from the extended family, Furstenberg noted a higher level of 
control over the child's behavior and a higher level of interest in 

her own support system independent of the family was an important dimen 
sion of her parenting role (197S) and evidenced a willingness to take 
responsibility fc 



impact of the extended family ha 
:ent of varying mothers' ages. T 
of the large number of single-pa 



" ( Family Planning Persoecl 



yet to be explored within 
is is especially important 
ent adolescent families, 
percent of the children 

p. 115). 



Intervention With Young Mothers and Their Infants 

In reviewing the outcomes of early parenting with respect to 
the mother-infant relationship, we are confronted with disturbing 
findings. Perhaps the most promising results, while few in number, 
have been the investigations of interventions designed to assist the 
young mother through her transition to parenthood. 

In a smaller (N a 39), quasi -experimental evaluation of the ef- 
fects of weekly mother-infant classes in a pediatric clinic. Badger 
(1974) found significant gains in mothers' knowledge of infant dcvelon- 
ment, nutritional needs and infant health care. Most promising were 
the significant increases in mothers' responsiveness to their infants 
and the infants' increased responsiveness to the mothers. Badger noted 
that the program had a significantly stronger impact on the behaviors 



In an educational and medical program for adolescents in Syracuse, 
Osofsky and Osofsky (1973; 1978) examined the mother-child relation- 
ship among 450 dyads. The authors noted the young mother's warmth, 

strong foundation upon which interventions were based. They also 
found a major weakness to bo a lack of verbal interaction. While 



The Children of Very Youne Mothers : Perinatal Risk Factors 

Thus far, we have discussed early pregnancy and parenting from 
the perspective of the young mother. Of equal importance are the 
consequences of early childbearing and childrearing for Che infants 
born to adolescents. Intuitively, we can guess that those infants 
are at high risk for medical, developmental and educational problems. 
Several factors have been brought to our attention by Crider (1976) 

of pregnancy in a physiologically immature woman has been repeatedly 

status, economic impoverishment, social isolation and emotional stress 
(McKendry et al., 1979). As with much research on early parenting, 
the investigations of the relationship between these factors and infant 
development have revealed inconsistent findings. They do, however. 

complications associated with adolescent pregnancy wasdiscussed by Ryan 
and Schneider (1976) at the University of Tennessee Center for tho Health 

of the neonate at birth among a predominantly black sample of 222 teens 
who were 19 years of age or less at delivery. The findings revealed 

:o have high rates of inadequate prenatal care, prenatal 



these patients tt 
complications at 









central nervous system depression, pallor and decreased tone were 
found to occur significantly more often in babies of adolescent mothers. 
These findings offer important information to be considered in the 

mothers. A methodological concern should be noted with regard to the 
author's comparison of their sample's results to a previously unspeci- 
fied sample of older teens and "of age" mothers . 

The findings, as discussed above, about perinatal risk and mortalitv 
of very young (s 16 years) adolescents, have been consistently 

throughout the obstetric and pediatric research (McGanity 



McKendry et ml.. 1979). Additional obstetric complications of 

i to have a significantly higher incidence of 
.c complications summarized by McKendry et al. 

id cephalopelvic disproportion {irregular size 
i head in relationship to the mother’s pelvic 
al., 1979). These problems have been related 

it pregnancy) immaturity of the mother (Ilatnik 
and Burmeister, 1977: Erkan, Rimer and Stein, 1972). 

neonatal risk has been closely studied by several authors {Grider, 1976; 
McKendry et al., 1979; Mecklenburg, 1973; Dott and Fort, 1976; 



adolescents wi 



at delivery {McGanity et 
fever (Coates, 1970), ar 
or position of the fetus 
structure) (McKendry et 
to the physiological ai 



Coates, 1970; Grant and Heald, 1970; Hardy, 1971; Youngs et al. 

1977; Seamens, 1965). Findings which were consistently documented 
by these authors indicated that the infants of young aethers were 
at high risk for perinatal, neonatal and infant mortality. Crider 
C1976) cited a North Carolina study of perinatal mortality in an age 
specific sample which found that the mortality rate was highest 
when mothers were under 15, and declined through the age of 20. 

The rate of morbidity (impaired medical and/or developmental 
functioning) was also found to increase significantly as the mother's 
age decreased. Mother's age and medical risks to the neonate included 
respiratory distress syndrome, hyperbilyrubinemia, fetal distress 
with anemia, fetal distress with asphyxia (Coates, 1970), low birth- 
weight associated with prematurity and low birthweight associated with 
small site for gestational age (Crider, 1976) . 

In studies where a comparison group of "of age” mothers were 
included in the designs.we are presented with different findings. 
Niswander and Gordon's (1972) discussion of the National Collaborative 
Perinatal Study results indicated no significant differences between 
mothers under 20 years of age and those over 20 with respect to 

more often when the mother was less than 15 years old. Their data 
did not support an association between out of wedlock births and 
perinatal risk. Dott and Fort (1976) concurred with the finding that 
the "unique medical problems [of the adolescent] are controllable and 
do not differ appreciably from older women" (p. 536). 

McKendry et al. (1979) hove summarited the limitations of 

of obstetric performance and neonatal status. The authors concluded: 



f m 




Hie prematurity r: 
ve only difference was the 



deliveries. 



significant predictor of perinatal oi 
adolescent's higher incidence ol 

The Louisiana Infant Mortality Study [Dott and Fort, 1976) 
revealed that younger adolescents were less likely to utilise 
antenatal services and that, when adequate prenatal care was gil 
the perinatal and neonatal death rate was significantly lower, 
authors discussed the role of social and demographic variables i 
outcomes of the infants of young women. In the discussion of t 



motherhood falls me 
and mortality are ; 



authors concluded that "the 1 
t heavily on the offspring . 
e greatest risks associated w: 



nrant morbidity 



bearing)'' (p. 536). 

In a report of the Collaborative Perinatal Study at Johns Hopkin 
Medical Center, Hardy (Neither et al., 1971) summarized the romifica 
tions of perinatal and neonatal outcomes in her statement: 

The scope of fetal wastage is two dimensional: 1) in terms of 
perinatal mortality; and 2) in terms of the perinatal insult, 
which while not sufficiently severe to cause fetal or neonatal 
death, results in long-term handicapping conditions of the 
surviving infant— for example, cerebral palsy, mental retarda- 
tion, congenital malformation, blindness, deafness and other 
neurological defects, (p. 238) 

This point was stressed as well by Dallas (1971). He extended 
Hardy's perinatal risk factors to conclude that "later fetal outcome 

of genetic, biological and environmental variables" (p. 2*19) 



i 'the development of the 
id relatively unstudied 
i been, however, a handful 



(Guttmacher Institute, 1976). There have bei 
of longitudinal studies of children born to * 

dosign and constitute our main sources of information regarding 

Developmental Outcomes of Adolescent Pregnancy 

The earliest and longest follow-up assessments of infants of adoles- 
cents were done as part of the Johns Hopkins Child Development Study 
sponsored by the Collaborative Perinatal Project. For this investigation. 
Hardy, Belcher, Stanley and Dallas C197S) defined adolescence to be 16 years 
of age or less at delivery. The sample of 4.SS7 mother-infant dyads was 

12 year period. The sample consisted of 706 aethers who were 17 years of 
ago or loss at delivery. At biTth, there were no significant differences 
between the under 16 and over 16 groups on perinatal or infant death rates. 
All risk factors were significantly higher for blacks than for whites. 

At eight months of age, infants were assessed with the Eavley Scales 



significantly higher scores on thi 
Hardy concluded that this was sugs 
practices" (p. 1224). At four yea 
the Stanford- Binet Intelligence Te 






profile and psychological impressio: 



i higher proportion of 



in of adolescents wi 



‘ Children (V 






K ( WRAT) . The children of adolescent 



mothers were also found to hi 
achievement and repetition of school grades on the twelve year 
assessment. Self-concept was measured by the Coopersmith and 
Piers-Harris tests. No significant differences were found between the 
children of adolescents and those of older mothers. 

information regarding the long term effects of early motherhood on 

of the mother are distressing and suggest a need for early and intense 



lack of empirical evidence about the childrearing practices 
of the mothers involved. While other studies using Bayley measures 

development were empirically demonstrated to be correlated with mother- 
infant transaction (Beckwith, 1973 ; Beckwith et al., 1976), the Hardy et 
(1978) study failed to assess the transaction process in a controlled 



data in a longitudinal study of low-income Black adolescent mothers 






whose parents married early and stayed married had the highest 



In a five year follow-up, Furstenburg ( 197 s ) compared children 
of young mothers to children of older mothers who were in nreschools. 
He found that children who were cared for by grandparents in the 
home scored significantly higher than those who were in preschools. 

The author concluded that the child's cognitive ability was enhanced 
as a result of the aid his mother received from her parents which 
allowed her to become more educated and socioeconomically advanced. 
These findings point directly to the long term assets of the mother's 
social support system. The study is limited, however, due to small 
site of the sample and the lack of a compnrison group of nonBlack 

Holstrum (1979) studied the intellectual, perceptual-motor, 
language and behavioral outcomes of premature infants at three years 
of age. Her findings revealed that socioenvironmencal and neonatal 
variables contribute significantly to the prediction of develop- 
mental outcomes. Socioenvironmental variables investigated included 
mother's age, material resources and amount of social stress. Follow- 
up simultaneous univariate analyses revealed that the age of the mother 
did not contribute to the developmental outcome of three year olds. 

Broman, .Nichols and Kennedy (197S) studied a sample of 26,760 
children born to mothers in the Collaborative Perinatal Project. 

They tested the significance of 169 prenatal and developmental 
variables in order to ascertain their ability to predict intellectual 
performance at four years. Their findings revealed that maternal 



education and socioecnomic status wore major contributors to explained 
variance in preschool IQ scores. The age of the mother was not found 
to be a significant predictor. Baylcy assessments at eight months 
were found to be predictive of delayed intellectual development in 
early childhood. These findings are particularly interesting in that 

18 years (n ■ 86) to those at age 18 and older Cn = 86), Oppel and 






physical, social, and psychological characteristics. Subjects 
were matched on economic status, birthweight, parity and race. 

Data were collected at six tc eight and ten to twelve years usir 

Test , psychological observations and t( 

biological mother wore at significantly greater risk on all measures. 
There was also a significant difference in the child's physical size, 
which rovealed more children of young mothers to fall below the 
third percentile in height. They also "displayed a trend towards 
lower weight" (P- 752). No significant differences in intelligence 
or psychological adjustment were found. Children of adoloscents were 
at a significantly lower reading level, however, and were rated to be 



conclusions reached by 









birthweights. Had these variables been controlled statistically 
rather than in the experimental design, the results would have been 
more general! table. Another limitation of this study is the fact that 
the data were collected for a purpose other than that for which they 



young mother appears quite dismal. Regardless of the methodology, almost 
every study has documented the intellectual, emotional, educational, 
developmental and medical risks associated with early pregnancy and 
parenting. Our only evidence of a more hopeful future for these 

mother's support from her family and the professional community. 

Our knowledge base is lacking in both the number and scope of studies 



into the consequences of early parenting fbrthe young mother and her 
child. It is to this specific gap in our knowledge that the present 



study was directed. 



CHAPTER 



METHODOLOGY 

The purpose of this study was to ascertain the contribution of 
mother's age, perinatal risk status, and socioer.vironmental, medical 
and educational resources to the prediction of mother-infant transaction 
and the mental and psychomotor development of the infant. The population 
from which the sample was drawn consisted of mother-infant dyads who were 
served by the College of Medicino at the University of Florida. The sub- 
jects were stratified on the basis of the age of the mother and were 
selected at random from the Birth Log at the Shands Teaching Hospital. 
Ninety-two mothers and their six months old infants participated in the 



The assessment procedures consisted of a six minute videotape of 

the B ayley Scales of Infant Development . Demographic at 
tal data were obtained from the Child and Family Development It 



is developed fc 



is study. Following t> 

:-centered protocol was implemented which was base, 
Is as assessed on tho mental and psychomotor scales 
the data collection procedures were implemented in 
of Shands Teaching Hospital. Tho sample, design a r 
ita collection and analysis are described in this c 
Chapter 1, the questions posed by the study were: 
it development and mother-infant t: 



as a function ox the age of the mother? 

I Is the relationship between mother's age 

social support system, infant's sex and i 
I What is the nature of the relationship bt 

measures at six months? 

l Is there a positive association between the extent of 









mother's social support system and 
!n keeping with the exploratory nature c 
') Is there a relationship between the 






tf the mother and ir 









relationship — warmth, reciprocity, responsive vocalization, 

after controlling for mother's age and education, infant's 
ethnicity, social support system and type of prenatal care 

mental and psychomotor development of the infant ofter 
controlling for the mother's age and education, the Infant’s 

Definition of Terms 



Mental Development Index (MDI) and the Psychomotor Development 
Index (P01) of the Bayley Scales of Infant Development. Thos. 
indices Teflect the mental, psychomotor, language and socio- 
eootional competence of the infant. 

Mother- Infant Interaction is the categorical identification 
of behaviors described in the Beckwith Behavior Scale . These 

Mor.responsive Behavior is that behavior which is observed 



to be self-initiated 
of another individual. 
Mother-Infant Transaction 
of interaction behaviors h 
Developmental Pclav refer 



T Psychomotor Development Ii 
it Development . 



Ush for developmental delay refers to a score between 

of the Bayley Scales of Infant Development . 

fk for developmental delay refers to a score between 

1 100 on either the Mental or Psychoaotor Development 



ic Bayley Scales o: 



Prenatal Care by Private Physician refers to those patl 
who received obstetric treatment from physicians in the 
Private Diagnostic Clinic at Shands Teaching Hospital. 
Public Health Department Prenatal Care refers to those v 
received obstetric care at a public health department cl 
Miternal- Infant Care Clinic Treatment involved patients i 
13 county area surrounding Gainesville, Florida. These 
patients received prenatal 
and pediatric care, family planning 

Teenage Pregnancy Team Care refers to patients wh 



care, family planning services, social service and nutritional 

class and an optional infant, parenting and family development 
education class. This treatment was received by women who 



’e district (Mahan, 



13) ! 



Is Teaching Hospital (S.T.H.) 



to care which was specialized for those women identified 
as having a high risk pregnancy. Obstetric and neonatal 

The Subjects 

The population of interest in this study was that of mother- infant 
dyads residing in North Central Florida who were served by the College 
of Medicine at the University of Florida, Gainesville, Florida. Utillz- 

records) available through the Shands Teaching Hospital, a stratified 
sample was drawn (N=2S0). Stratification was on the basis of mothers’ 

as outlined in Appendix A. Socioeconomic and cultural representativity. 



in the Pediatric Clinic. When the families -- often including fathers, 
friends and extended family members — arrived at the clinic, a brief 
explanation of the procedures preceeded the assessment. Subjects in 



f the developmental testing 
variables under investigation 



in order to prevent bias during the t 
A). Treatment of participants was ir 
the American Psychological Association and the Committee for the 
Protection of Human Subjects at the University of Florida. 

Following an explanation of the procedures, the families were 
requested to come into the playroom whore a mat and toys were available 
for ploy. Mothers were encouraged to engage in a brief play period 

t mothers participated in free play with their 



then recorded as 
infants. The ir 
was designed to 







administration of the scales. After the evaluation, the results regard- 
ing the sental, psychomotor, language and socioemotional growth of the 

each area of development. Parent's questions were encouraged and 

phase proceeded and focused on the specific strengths ai 
observed in the baby. Delayed or problematic development was ex- 
plained and appropriate protocols for remediation were discussed. 

It was emphasised that many of these delays found at six months could 



and prescribed activities. Where applicable, developmental, 
nutritional and medical referrals were made to the appropriate agencies. 

and a photograph of their baby to take with them. 

Following the assessment. Infant and Family Development Specialists 
interviewed the mothers to obtain demographic data. This was done 
in order to insure that the examiner remained naive to the age and 



The Bayley Scales of Infant Development were choson as a direct 
isure of the infants' psychomotor and mental abilities. The 

eye-hand coordination, problem solving, exploratory and manipula- 






Additional features of tl 

Appropriate features of ' 
were highly attractive t( 

reliability coefficients 
Werner and Bayley (1966) 



a instrument wore its adaptability to tf 
availability of a trained evaluator. 

10 test include the test materials, whii 

Hit to be held by the mother. Split-ha3 

12, respectively (Bayley, 1969). 
it-retest reliability (with eight month 




Inter-observer agreement is another aspect of reliability studied 
"markedly higher" than independent assessments since the same assessment 







er-observer reliability was : 
i be found in Appendix c. 



Perinatal 



In order to assess the perinatal (last month of pregnancy through 
rst month of life) risk status of tho infant at birth, the Prenatal 
id Intrapartum Risk Scale (Hoble et a!., 1973) was adapted for use 
i this retrospective design. This instrument was developed as a 
■stem for the prospective analysis of perinatal risks and rates 
rious complications in prenatal (maternal), labor and delivery and 
onatal screening characteristics (see Appendix D) . Information 
garding the risk status of the neonate was obtained from the 



way to investigate behavioral components of 



In order to examine parenting behaviors, a low- inference obser- 
vation system was used. The measurement of maternal-infant interaction 

be measured through the use of the Beckwith Behavior Scale. The 
scale was previously used by Beckwith (1976) and Grossman (1979) 
to analyte parent-infant transaction in two separate studies of 
one, three, six and eight month old infants and their mothers. 

The Beckwith Behavior Scale consists of 27 behavioral categories, 
each of which is assigned individually to parent or infant behavior. 

The behavioral categories of the instrument were solocted for 
their appropriate record of "parenting skills" which have consistently 



demonstrated a strong relationship to infant development and wi 
focal point of this study: 

1) The constructive expression of affect (both positive ai 

2) The ability of the parent to become in tune perceptual! 



cognitive and emotional development. 

3) The ability of the parent to interact with the child 
in a manner which is responsive to the actual state 
of tho child as observed and interpreted over time. 

The behaviors and their descriptions are presented in Appendix 8. 

Because of tho highly sensitive and potentially ambiguous nature of 

instrument within the experimental context under investigation 
and obtain appropriate estimates of intercoder reliability. A 
reliability study was previously implemented with Beckwith by computing 
a Poarson Product-Moment Correlation on independent ratings of 
two observers. On 18 behavioral categories, the coders were found 
to have a mean agreement of r = .92 (Beckwith, 1971: Beckwith et al., 
1976). Similar observational records have boon found to have predictive 
validity from observational records at nine months to Bayley mental 



studies assessed ti 
mental and socioeconomic si 
The decision was made 






aspects of mother-infant transaction. The instrument was originally 
constructed for observations or infants and bothers in the hone. 
Certain variables (such as floor freedom and mutual gate during 
feeding) were not applicable to this investigation, toother issue 



lich influenced ti 






original variables were substituted with ones which wc 
to the simulated playroom setting in a study of six s 



haviors were coded every five seconds or when the behavior changed . 
rather than every 15 seconds as originally implemented. The rationale 

analysis of the process as behaviors occur in a five (rather than IS) 



havior are measured consistently— has been a subject of great concern. 
This concept is best clarified by Cronbach and Rajaftnam (1963) in their 



of observations to which it belongs " (p, 144). 






experience in coding parent-infant transaction videotapes. In 
another study (Eyler, 1979) these observers evidenced skins in 
analyzing observable behaviors of Bothers and their premature new- 

numerous examples of each behavioral category. The observers were 
assessed initially and at randomly determined periods throughout 

behaviors were rated consistently. Fifteen of the videotapes were 

reliability. Table 1 presents the Pearson Product-Moment Correlations 
between the frequencies reported by the two coders. 

subsequent analyses and to represent more global dimensions of 



■ was subjected to a Principle-Component analysis using tl 
rotation. The results of these analyses are discussed ir 

Statistical Analyses 






Inter-Observer Reliability of 



Initiating Behaviors 
Repetitive Nonverbal Bi 

Affectionate Touches 

Repetitive Verbalitatio 
Baby Behavior 
Bid to Caregiver 



Baby Explores .1 

Mother's Positive Response -I 
Mother's Contingent Ver- .1 



Mother's Ignoring Response .1 
Baby's Positive Response . t 
Baby's Negative Response 
Baby's Contingent Vocal- * 



Baby's Ignoring Response 



Mother's Ignoring Response 
Baby's Positive Response 
Baby's Negative Response 



Baby's Contingent Vocalization 



Baby's Ignoring Response 



it development a; 



the more global dimensions ol 
analyses, a correlation matrix of the 27 bohavioral categories was 

analysis, five dimensions of mother- infant transaction wero defined 
and each subject's incomplete composite component score was calculated 



a positive 



loading on the component and the subtraction of the number of 

reliability of the observers was computed on each of the five com- 
ponent score dimensions using a Pearson Product-Moment Correlation 
procedure. These analyses were executed using the Statistical 
Package for the Social Sciences CSPSS) (Hie et al., 1975). 

In the first multivariate multiple regression analysis, the 



psychomotor development w* 



birth order, yearly i; 
i, perinatal risk seal 



origin, social support s! 

The second multivariate multiple regression analysis addressed 
the question regarding the ability of the transaction components to 



predict the mental and psychomotor development of the infant. 

In this analysis, montal and psychomotor development were regressed 
on mother's age and education, baby's sex and birth order, ethnic 
origin, yearly income, social support system, perinatal risk status, 

executed using the General Linear Model program of the Statistical 
Analysis System (SAS) {Barr et al., 1976) . 

Limitations of the Study 

The use of videotape analyses in a low- inference observation 

which the adult subject is willing to express in the given situation. 
This effect is confounded as well by the atmosphere found within 
any medical setting; this often produces anxiety in the mother 
and thus affects infant behavior. In an attempt to alleviate 

'playroom" setting 



was simulated in the Pediatric Clinic. 
The purpose of an evaluation 



ir use in diagnostic and pre- 
rant's strengths and limitations. 



those who responded ■ 



in Che stud/. Those subjects who were contacted, but did not pat 
ticipate may differ systematically from those who participated. 

A final limitation placed on the study is the ex-post-focto 
or correlational nature of the design. While associations and 
relationships among the variables can provide useful information, 
no inferences of causality can be interpreted from the results 



10 behavioral 



collected and anal> 






specific saatplo. In addition, tho study was designed ti 
the mother's ago, social support system, perinatal risk status, 
prenatal medical care, and participation in childbirth and parenting 

prediction of transaction and development 
results of the analyses are presented and 






based on the fact that relatively little is known about the develop- 
mental outcomes of very young mothers and their infants. The analyses 
were implemented in order to ascertain the contributions of the 
mother's age, social support system, perinatal risk status, type of 
prenatal care, type of prenatal childbirth education and type of 
parenting education as they related to mothers’ transactions with 
their infants and the infants' development. The questions addressed 






questions posed by the study, the dimensions of mother-infant 
transaction were studied. The number of behaviors in each category 
of the Adapted Beckwith Scale were first tallied for oach subject. 

A correlation matrix of the variables was then subjected to a Principle 
Components analysis. 



accounted for 46 percent of the variance. Table 3 reports the 
loadings of the variables on each component. Table 4 reports the 




Component Score 1 (Warmth) * Affectionate Touches - 



Mother's Positive Responses * Initiating Bids - 
Baby's Exploratory Behavior 

Component Score 3 (Responsive Vocalisation) = Baby's Vocali- 
sations e Mother's Contingent Vocalisations * 
Baby's Contingent Vocalisations - Mother's 



I 5 S 3 2 



t 1 § I I i~ 1^ a” I I I i I ! 



HM! I 

iHH I 
U!H 1 

mu. i 



u i M j 
i!iSi|iiiP 



HUH! | 
s s 8 1 8 a I. I 
II. i I 18 I i 

MIMIJ § 



mm i s 

JI 
HI 

Hi 



iiSl 



Component Score 4 (Negative Affect) » Mother's Commands 



Mother's Criticisms ♦ Mother's Interfering 
Mother's Negative Responses 

was implemented. The correlation coefficients are reported in 
Table 5 and indicated that the individual variables chosen to 
compute the component scores are highly correlated with the new 

be correlated with the components were not. These coefficients 
supported the interpretation of the composites of variables selected 



This permitted 






assessment of interobserver reliability for the composites. The 

scores are roported in Table 6. The results of this analysis 
indicated that the two observers were consistent in the coding of 



I 

I 

I 

1 

1 

I 

■s 



[H MMH 


1 1 1 M 


III m;i| 


s M M 


il M M M 


1 5 111 


jj M M M 


n«H 


Il mill 


U.M? 


ill 1 1 1 i i , 

i ilillPlIflll 



I S a a s i 3 1 



S22§ 2 2 s = ss 



Interobserver Reliability of 



Reciprocity 
Negative Affect 






Descriptive 

independent and dependent variables wi 
of 77 mothor-infant dyads- Frequency distributions wer 
fbr the independent and dependent variables and are reo 

dependent variables are presented in Table 10. 

An inspection of of the distributions of the measi 






t indicated tl 



indicated that the entire sample Kas within noi 
development at six months of age. The means oi 
considerably higher than those reported in the 
Infant Development Manual (Bayley, 1969). The 



scans and frequency distributions 



of the sample are equivalent to th< 
Interpretation of these findings ii 
Interobserver reliability was 
Pcarson-Product Moment Correlation 
The results of this analysis are presented in 1 
if interobserver reliability 






discussed in Chapter V. 



Variable Fluency 


Variable Frequency 


Mother', Are 


BabV, Sex 




Female 37 

< 53,000 19 


Mother ' s Education 


„ 




1 Cohab. Support Only 33 

2 cSJtoJ. to? " 38 

3 aKd^KT * 






sSSSSfr” 





Frequency Distributions _ for 



Variable 



Frequency 















Mental Development Ii 






‘d Deviations for Scores 



Reciprocity 

Negative Affect 
Nonresponsive Stimulation 



the type of prenatal care to be highly « 
of prenatal childbirth and postpartum parenting education receive 
by the mother. The type of prenatal care received by the mothor 
determined to a great extent the type of educational program she 
was offered. As a result, prenatal childbirth education and 
parenting education were omitted from further analyses. The 
variable "type of prenatal care" contained more information due 
to the differences in prenatal and parenting education programs 
offered in conjunction with prenatal medical care. The cross 

The correlation matrix is presented in Table 12 and 
indicated that the perinatal risk status of the mother and infant 
were not correlated with the presence or absence of prenatal 
complications. Complications found among women in this samole 
included anemia, toxemia, venereal disease and infection. The 

due to the fact that the measure of perinatal risk included 
prenatal complications. It is possible, however, that the 
rating system employed by the scale is not useful for studies 
which are retrospective in nature. Another possible interpreta- 
tion is that the scale may not be sensitive tc 



If the many prenatal complications present in adolescent patients, 
i a result, the presence or absence of prenatal complications 

The Relationship of Mother's Age. Perinatal Risk Status and 



was to obtain information regarding 
and parenting, a number of hypotheses were tested. Two multivariate 

procedures. These analyses, which addressed the ability of the 
independent variables to predict dm 
infant development, were subjected 

rate was set at .05 for the multivariate 
approach, this was divided by the total : 
of dependent variables such that the criterion for significant 

follow-up analysis, the criterion for significance was set at 



transaction with her baby; a 



er to facilitate positive 



he nature of the relationship between mother's age i 
nd development. The specific questions addressed ii 






Question Or.e: Do infant development and mother-infant interaction 
vary as a function of the age of the mother? 

Question Two: Is the relationship between mother's age and each 
dimension of transaction and Infant development 
linear after controlling for all independent 



To test the hypothesis that there would be no relationship between 
mother's age and interaction and development, a multivariate multiple 
regression analysis was used. In this analysis, the dependent measures 
were mental development, psychomotor development, warmth, reciprocity, 
responsive vocalization, negative affect and nonresponsive stimulation. 
The independent variables were mother's age and education, baby's sex 
and birth order, ethnic origin, yearly income, social support system, 
prenatal complications, perinatal risk status and type of prenatal care. 

The results of the univariate tests of the contribution of each 
dependent variable to overall prediction indicated that only mental 
development was significant. The results are presented in Table 13. A 
visual inspection of the plot of the residuals against the predicted 
values of mental development revealed that the data met the assumption 
of homoskedasticity (homogeneous error variance around the regression 
lino) and were appropriate for the analyses. 



The tests of significance of the multivariate main effects (Table 
14) indicated that the age of the mother did not contribute to the overall 
prediction of mother- infant transaction and infant development fa=. OS) . 
but did contribnee to the prediction of the infant's mental development 



Rosuits of the Univariate Tests of the Contributions 
of Several Dependent Variables to Mother- 
Infant Transaction and Infant Devolopcent 



Psychomocor Development 



negative Affect 
Nonresponsive Stimulation 



10 Multivariate Significance 



Results ol 

Tests of Contributions t< 

Transaction and infant Development 




•Transformation 



)1). The results of this analysis did not support the hypothesis 
the psychomotor development of the infant 

f the univariate analyses are presented in Tables IS and 16. 
preceding multivariate multiple regression analysis was 

Is there a positive relationship between the 
extont of prenatal care, prenatal and postpartum 






mother's social support system and transaction and 

The analysis of the multivariate main effects (Table 14) revealod 
that the presence of prenatal complications and the type of prenatal care 
received by the mother contributed significantly to the prediction of 

of the variance in mental development. The follow-up analysis of the 
pairwise comparisons of each type of prenatal care indicated significantly 
higher means for infants whose mothers received Teenage Pregnancy Team 
care when compared to those receiving treatment by a private physician 
and Shonds Teaching Hospital High Risk Clinic. The results of the pairwise 



comparisons and the adjusted means for each prenatal care group are 
be answered with respect to the association between prenatal care and 



Tests of Significance of Contribution 
the Prediction of Infant's Mental Development 






Regression 

Coefficient 






Ethnic Origin 



Social Support System 5.86 
Prenatal Complication -13.16 
Perinatal Risk .12 



Test of Significance of Contribution of 
Continuous Variables to Prediction of Infant's 
Psychosjotor Development 



Baby's Birth Order 

Mother's Education 

Social Support System 
Prenatal Complications 



Pairwise Comparisons of Types of Prenatal 
Care as Predictors of Infant's Mental Development 



Private Physician— Public Health 
Private Physician— Maternal Infant Cl 
Private Physician— Teenage Pregnancy 
Privato Physician— S.T.H. High Risk Clinic 
Public Health-Maternal Infant Care Proj. 
Public Health— Teenage Pregnancy Team 
Public Health— S.T.H. High Risk Clinic 
Maternal Infant Care Proj. -Teenage Pxeg. 1 









I. High R: 



Mean Mental Development of Infanta 
in Each Prenatal Care Group After 
Adjusting for Variance Explained by All 
Other Independent Variables 



Prenatal Care Group 



Teenage Pregnancy Team 
Public Health Department Clinics 
Maternal-Infant Care Clinics 
Private Physician 
S.T.H. High Risk Clinic 



educational programs are discussed in Chapter V. 

The data did not support the hypothesis that either perinatal risk 
status or the quantity of social support received by the mother was 
related to her transactions with her infant or the infant's development. 
In addition, it was found that no independent variables contributed 
to the prediction of the mother- infant transaction process. 

The second sailtivariate multiple regression analysis was imple- 
mented in order to ascertain the ability of the transaction components 
to predict infant development. This analysis was also directed to 
the questions regarding the mother's age and prenatal and perinatal 
variables as predictors of infant development when the variance 
explained by transaction was partialled out in the model. The second 
analysis was designed to answer the following questions: 

Question Three: What is the nature of the relationship between 
prenatal medical care and development at six 






Question Eight: 



on infant development measures at six months? 
Is there a relationship between the age of the 
mother and infant development after 






mother's education, perinatal risk status, ethnic 

type of prenatal care and education? 

regression analysis. Mental and psychomotor development were regressed 
on mother's age and education, infant's sex and birth order, warmth, 
reciprocity, responsive vocalisation, negative affect, nonresponsive 

From the multivariate tests of significance (Table 19 ), it can be seen 

isations and type of prenatal care contributed to the overall p: 

The results of the univariate analyses are presented ir 
This represents the contributions of menta. 
and revealed that both models were significant. A visual inspection 

development. The plot of the residuals against mother's age evidenced 
was a positive linear relationship between the age of the mother and 
10 percent of the variance in mental development. Tho regression 



Results of the Multivariate Significance 
Tests of Contributions to the Infant's 
Mental and Psychomotor Development 



Reciprocity 

Responsive Vocalisation 
negative Affect 
Nonrosponsive Stimulation 

Baby's Birth Order 

Ethnic Origin 
Mother's Education 

Prenatal Complications 
Perinatal Risk Status 




"conversion 



Criterion 






:s of Significance of 



Mental Development 



Tests of Significance of Contribution of Continuous 
Variables to the Prediction of Infant's Mental Development 



Variable 



Weights 



Warmth 

Reciprocity 



Negative Affect 



Ethnicity 






Social Support System 
Prenatal Confiscations 




coefficients indicated that for each year of aether's age, the infants 
differed, on the average, by 2.6 points on the Mental Development Index 
and by 1.2 points on the Psychomotor Development Index. (Table 22). 

Question ten was concerned with the relationship between perinatal 
risk and development at six months. No significant association was 
found to exist between perinatal risk and either mental or psychomotor 
development. 

Tho presence of prenatal complications (anemia, toxemia, infection 
venereal disease) was found to have a negative relationship with the 
infant's mental development and accounted for 12 percent of the variance. 
No deviations from linearity were evidenced on the plot of the residuals 
against prenatal complications; it was therefore concluded that there 
was a negative linear relationship between prenatal complications and 
mental development. No significant relationship between prenatal 
complications and psychomotor development was found. 

Responsive vocalisation, the component which included the behaviors 
baby's vocalisations, mother's contingent vocalizations and baby's 
contingent vocalizations, was found to have a positive relationship 
to the infant's psychomotor development and accounted for 11 percent 
of the variance. No significant relationship was found to exist between 
responsive vocalization and mental development. 

The type of prenatal core contributed to the prediction of 
both mental and psychomotor development. Pairwise comparisons of the 
four groups indicated chat the means of those infants whose mothers 
received treatment by a private physician scored significantly lower 



Tests of Significance of Contribution to the 
Prediction of Infant's Psychomotor Development 



Responsive Vocalisation 

Nonresponsive Stimulation 

Baby's Birth Order 
Ethnicity 

5ocial Support System 
Prenatal Complications 



:s and the Teenage Pi 



from Maternal and Infant ( 

Infant Care Clinic patients and Shands Teaching Hospital High Risk 
also significantly higher than the infants of Shands Teaching Hospital 
presented in Tables 23 and 24. 

of the first and second analyses with regard to the significance of 
the type of prenatal care as it related to psychomotor development. An 
inspection of the adjustod means for each prenatal care group (Table 2S) 
indicated large, but nonsignificant differences on the transaction 
components. This variance was not accounted for in the first analysis. 
In the second analysis, partialling out the variance explained by 
transaction yielded a significance association between the typo of 
prenatal care and the psychomotor development of the infant. 

The question regarding delays in infant development could not 



the mental or the psychomotor scale. As a result of this analysis, 
however, certain variables have been identified which do contribute 
to the prediction of developmental risk in infancy. The variables 
which were found to be associated with negative outcomes in mental 
development were: 1J the young age of the motherland 2) the 
presence of complications during pregnancy. Negative outcomes in 
psychomotor development were associated with a lack of responsive 



S * J « 1 =. » s J I 
335“* 5 53 5 j 
11335 3 H ? 3 




Means for Prenatal Care Groups after Adjusting for Variance Explained 
by Transaction Components and All Other Independent Variables 




Private Physician 
Public health Department 
Maternal Infant Care Clinics 
Teenage Pregnancy Team 






prediction 



Mother-Infant Transaction as a Pred ictor of Infant Development 
One of the fundamental questions investigated in this study 
concerned the relationship between mot! 
the mental and psychomotor development 

Question Nine: Are the transectic 

reciprocity, responsive vocalisation. 



id psychomotor 



variable separately. The F statistics for nent 
development were 2.34 and 3.36, respectively at 



following 



F = [Sun of Squares [Full Modell-Sum of Squares (Reduced Modelll/S 



[4807, 13U - 2669.82951 / S 



Psychomotor 

Development F = [12860,4948 - 9SS2.88691/ 5 






», reciprocity, responsive vocalize 

Followup tests [Tables 21 and 22) supported only the hypothesis 
that the unique proportion of variance accounted for by responsive 
vocalization contributed to the prediction of psychomotor development. 

in psychomotor development. Based on the positive regression 
weight, it can he concluded that there is a positive relationship 
between responsive vocalization and the infant's psychomotor development. 

le residual plots indicated that the relationship 









id socioenvironmental, m 



prenatal and porinatal factors. ; 

development In an aje-specific sample. In the first analysis, the 
id development were considered to be 
if early pregnancy and parenting. Mental development 



found to be associated with the age of 
prenatal care received by the mother an 



prenatal complications. 



The second analysis was concerned with the prediction of the 
developmental outcomes of the infant. Several variables were found 
to be associated with the infant's development. The variables which 
were identified as predictors of mental development were: 1) the 
age of the mother: 2) the type of prenatal care received by the 
mother; and 3 ) the presence of prenatal complications. Psychomotor 
development was found to vary as a function of: 1) responsive 
vocalisation of the mother-infant transaction process; and 2) 
the type of prenatal care received by the mother. 

The dimensions of mother-infant transaction were found to 
contribute a significant proportion of shared variance to the 

which contributed a uniquely significant proportion was responsive 
vocalisation. The results of the study and their implications 
i discussed in Chapter V. 



CHAPTER 



DISCUSSION AND IMPLICATIONS 



Che mother, prenatal anc 



In this study, the most important questions were concerned 
the multidimensional outcomes of early pregnancy and parenting, 
itudy was designod to explore the relationship of the age of 
perinatal factors and socioenvironmental, 

le development of the infant. This 









The most important questions posed in Chapter I asked "what 
re the behavioral characteristics of the very young mother? , . . 
iw does she relate to her baby and what is the association between 
!T style of mothering and her baby's development?" The questions 
dressed several dimensions of early family development. 















of her baby 1 s mental development wl 
as a dependent variable. The age of the mother wi 
with her baby's mental development when the proportion o: 
accounted for by mother-infant transaction was held constant. 7110 
data suggested that tho infants of younger mothers were less competent 
on a measure of mental development and that, as mother's age increased, 
so did the infant's mental development. 

The problem of multicolinearity could not be dealt with 
adequately in this study due to the need for an extreme Urge data set. 
It is therefore difficult to tease out the unique contributions of 
mother's age and education, ethnic origin, birth order, yearly income 
and prenatal complications. For instance, it remains unknown whether 

young or if development is threatened by the mother who is prone to 
problematic pregnancy due to poor nutrition (anemia and toxemia) , 
infection and venereal disease. Specifically, are mothers who are 
more iikoly to have complications during pregnancy and have fewer 
material resources also less able to stimulate the mental development 

The significance of the association found between mother's age 
and the infant's mental development is in accord with other research 
concerned with the infants of adolescent mothers (Hardy et el., 1978). 

! present findings indicate a need for early and 
md educational intervention protocols which are 



intense developmental 
designed to enhance tl 



The findings of this and other studios tClarke-Stewart, 1973; 
Beckwith et al., 1976) have documented the potential of the transac- 
tion process to enhance infant development. We therefore have support 

intervention. The findings of this study also suggest that the 
dimensions of mother-infant transaction generalise across the age of 
the mother and that the young mother is as adept in her ability to 
facilitate positive transaction whth her infant as her "of age" peer. 
The strength of the mother-infant relationship is perhaps one that is 
able to be focused on in our attempts to help mothers enhance their 
infant’s mental competencies. As professionals, there is often little 



biological threats due to prenatal complication that relate to infant 
development. We can, however, support young mothers in their 
transition to parenthood and their development of a transactional reper- 
toire which is responsive to the infant and thus facilitative of their 



Prenatal and Perinatal Factors at 
Educational Resources as Predictors o; 









Previous research regarding early parenting revealed the mother’s 
social supporc system and the professional services she receives to 
have a relationship both to her development as a mother and her 
infant's competence (Furstonburg, 1978; Kotelchuck, 1979; Brazelton and 






were investigated in this study, as well. The data 
significant relationship between the quantity of social support 
and development and transaction. This was surprising and suggests 
that perhaps the basis upon which support was quantified— cohabitation. 



income and childcare assistance— was not an appropriate measure of 
the qualitative aspects of support which hove been associated with 
family development. An additional instrument to assess the qualita- 
tive characteristics of the mother's social support system would 
assist in future studies. 

The findings indicated the positive association between more 
comprehensive models of prenatal care and the mental and psycho- 
motor competence of the infants. The most significant differences 
in infants' mental and psychovotor development wore found to exist 
between prenatal care which offered only obstetric services and those 
which included either an optional or a mandatory prenatal and 
childbirth education program. The highest means on infant develop- 



in the model which included prenatal and postpartum parenting 
education as well as social service referral, nutritional and 
short term crisis counseling (Mahan, Note 2). 

In interpreting this finding, it is important to note 
that a considerably larger proportion of the invited sample of the 
Private Physician care group patients participated in this study 



four groups, whereas the measures taken on private patients reflect 
a more random selection. Another consideration to be taken into accoi 
is the fact that subjects were self-selected into each type of 

and as such, no causal inferences with respect to differences between 
groups can be made. No outcomes can be said to be associated with 
the prenatal or parenting education components of the models due 
to the fact that these variables were excluded from the analyses. 
These results do, however, suggest a need for more controlled'es- 
perimontal designs which would permit the investigation of the 

relationship and infant development. 

The results of this study indicated that the young age of 

was surprising that no infants in this sample (which consisted of 

(the clinical criterion for delay) on the Bayley Scales of Infant 
Development . Several possible explanations of this deserve mention. 

fell as the fact that the infants participated 






influenced the infant's le\ 
stated to be a goal of the 
consideration is the snail 
infants (those who were bor 



optimal performance which was 
(Bayley, 1969). A third 

prematurely or had neonatal complications) 



; k infants sampled, four participated in this study. 

The data were unable to answer the question and the identification 
of delay in an age specific sample thus remains in need of future 
investigation. 

Of benefit to our knowledge base would be the longitudinal 
assessment of the Infants of adolescent parents. That these infants 
are at risk has been woll documented in the literature. The findings 
presented in this study indicated that differences exist as early as 
six months of age. It is the subjective opinion of the author 
that a major factor in tho success of patient follow-up lios in the 
direct communication by telephone to advise them of services offered 
to the family. In explaining the procedures carefully, questions 
may be answered and parents may be made to feel that they were 
lucky* to be chosen. This approach was used successfully in a 
seven year follow-up of the Collaborative Perinatal Study (Dallas, 1971). 

A more thorough assessment battery for long term follow-up 
would be an asset as well. The use of the Behavior Profile in the 
Bayley Scales of Inf ant Development and its relationship to mother- 
s another unexplored area of early parenting. 






of social support would contribute to future investigations and 
yield valuable information. 

An analysis of the subscales (language, social, cognitive and 
gross and fine motor shills) of the mental and psychomotor scales 
would be of assistance in ordor to mahe early developmental inter- 
vention moro appropriate for each individual infant and family. 
Mother- Infant Transaction as a Predictor of Infant Development 
The relationship between mother- infant transaction and 
infant development was one of the most important questions in this 
study. The findings revealed responsive vocalitation to be positivel; 

contribution of the mother-infant transaction components was also 
found to he related to the infant's psychomotor development. 

infant relationship is important to the infant's development of 
competence. We also have reason to believe that more comprehensive 
interdisciplinary models of prenatal and perinatal support ore 
associated with enhanced development of the infant. These findings 
suggest several considerations in the design of parent and infant- 
centered interventions for the young parent family. There is reason 
to believe that early and prolonged intervention with young parents 

provided by the mother and thus enhance the development ol 









The findings discussed in this study indicate that there is 
a need to reach both parent and child at the earliest possible 
moment and in a most comprehensive approach, for in this way, 
individuals will be given the opportunity to develop to their 
maximum potential. Meeting the special needs of the young parent 
family presents a multifaceted challenge to efforts on the part 
of the professional communtiy. 

Although the findings of this study do not indicate the 
extended family to be of importance, a special concern with the 
adolescent mother Is chat our efforts must be focused toward not o 

extended families, as well. This was acknowledged in the studies 
of Furstenberg (1976, 1978) and Kotelchuck (1979). Often this will 



At the heart of this approach is the primary prevention of 
early pregnancy— both repeat and first pregnancies— to individuals 

of confidential family planning services and curricula designed to 
deal with the issues of human sexuality and family development, 
it is anticipated that young people will become more responsible 



in their sexual activities. 

a mother and her baby's development. As noted earlier, the philosophical 



basis of this study was a strong belief in the positive characteristics 
of the young parent— courage, enthusiasm, adaptability and, above all, 
an optimistic view of the future. It is hoped that the results of this 
study and the literature presented herein will allow our future efforts 
to focus on the qualities of the mother-infant relationship in order 
to enhance the development of the infant and strengthen the family. 

continue their pregnancies and undertake the tasks of motherhood. 
Remember, too, that most individuals, regardless of age, come to parent- 
hood relatively unprepared for the responsibilities of caring for and 
nurturing another human life. The positive growth and development of 
those young parents and their children is dependent upon cur interdis- 
ciplinary efforts to support them in a comprehensive manner as they grow 
together as a family. 



PARENT CONSENT 



body and mind are developing. The study involves making a videotape 
(like a television film} of you and your baby playing and using the 
Bayloy Scales of Infant Development to study your baby's mental and 
physical abilities. Ne will bo happy to answer any questions before, 
during or after the study. You will be informed of the results of 

book of baby exercises, games and learning activities. 

Ne are looking forward to working with you and your family and 
hope you will agree to be a part of our study. If you will agree to 
participate, please sign below. 

In the event of sustaining a physical injury which is proximately 
caused by this experiment, professional medical care will be provided 



, exclusive of hospital expenses. 



my child and using the information and videotapes for research and 
teaching purposes. I also realise that I may change my mind and 
withdraw ay permission at any time. 






Parent's Questionnaire 

Bayley Scales or Mental i 



Evaluation Protocol 

prior to test date. They will be mailed the reminder postcard one week 
prior to testing and phoned to confirm the appointment two to three 
days prior to testing. 

Upon arrival in the Pediatric Clinic, they will be brought into the 
Developmental Clinic Playroom and the Assessment Specialist will explain 
the procedure for the freeplay videotape and Bayley Scales of Infant 
Development. Upon agreeing to participate in the study, the mother will 



The freeplay situation will be videotaped ant 
sessment administered. The Developmental Specialist wj 
e family into the waiting room and explain the results 



mother learning activities. 



infant's developmental strengths and weaknesses, and give the mother 
illustrated descriptions of the activities demonstrated. Following 

information. 



l '?SE“ r ' 




— Eg? 



— iS ST 



DEFINITIONS 



Adapted 3e 






Maternal Behaviors 

1. Comments : positive verbalizations; all positive vocalizations 
including questions, praises, suggests, focuses verbally. 

2, Commands : mother-oriented, directive and forceful verbalizations 






Initiating behaviors : self-oriented 
getting baby's attention in soiao non; 
direct baby in a different direction 



ited maternal behavior; 









quality, such as presenting different toys 
its : rapid bursts of maternal behavior which 






on-going .activity, includes I 



iches baby to distract, inhibit 
-tting, moving object from hands, 









•s vocalisation, babbling, gurgling, 



it mother; not frowning, not grimacing.. 






it contingent on mothc 



IS. Maternal positive responding : caregiver responds to infant 
positive bid or distress in a positive manner by permitting, 
giving, engaging, heiping, accepting, etc. Does not include 



turning away, or stopping a baby's initiations. 

20. Maternal ignoring : mother ignores bids or activity of baby. 

positively by smiling, reaching, pointing, vocalizing, etc. 



Baby's negative responding : baby responds to Bother's bid 
by fussing, crying, turning away, etc. 

Baby ignoring : ignores bids or activity of mother. 
Face-to-face orientation : mother is in a position facing 



verbalization to infant 






vocaii ration by infant. 

responds vocally to mother's behavior. 



|s3|“2?SSS3?* 







ssriSH'S‘si,H-rs;, 

s 3 ‘; l" sshs? ;r £: " » *“■■ 






sssr 

SSSrSaas* 

c £i^iv^^ r ' 

SsSSwSt^sSS- 

iliiisii: 




only.) 







APPENDIX D 



PERINATAL RISK SCREENING 
Calvin Hebei (UCLA) 





2. Abruptio placentae 
5. Postterei; 42 weeks 









■ Multiple pregnancy 
Fetal bradycardia 

Prolapsed cc 



Neonatal Factors 






General anesthesia 



Resusciation 



Meconium aspiration 
Congenital pneumonia 
Anomalies of respira- 



Feeding problem 
iltiple birth 



Transient tachypnea 
Metabolic Disorders 
Kypoglycdmia 
Hypocalcemia 
Hypo/hypcraagne5emia 
Hypoparathyroidism 
Failure to gain weight 
Jitteriness 









1. Hyperbilirubinemia, IS 

2. Hemorrhagic diathesis 

3. Chromosomal anomolies 



r. Central Nervous System 



2. Seizures 



REFERENCE 











“su. 

n sS££r*3-S2*£* 




“SssSni^.?s? 



“"S&i, SSTS- 

“is SSSr^ 5 

^ss&aScHr**- 

'"Sbk "=S5 , mJt'ES 

1SafiH?swS? J 







ns^smms& 

“A»ass,-a“ 




“aSisSt 

s “‘ g!rs!£" ,a"jSir s - 







'ISSrSssssHSss.'^ 



~«"u 






n elementary 



Julie Anne Hofheimer we 

Andy and Gary, she resided in Jacksonville as we 

and eirly childhood education from Florida SI 
and her M.Ed. In early childhood and elementary education from the 
University of North Florida in 197S. 

Julie taught first grade and kindergarten in Orange Park and 
Jacksonville. She also taught early childhood curriculum at the University 

and Secondary Education. 

Upon beginning her doctoral program, Julie was a seminar leader in 
the Childhood Education Program at the University of Florida. From 
September 1978 until June 1979, Julie served as Infant and Family 
Development Specialist on the Adolescent Pregnancy Team in the Department 

Teh assistant in infant development for the Department of 
dsion of Neonatology. Throughout the year, Julie taught 
graduate students in Early Childhood and Family Development 
te Department of Early Childhood Education, 
her future remain tentative, but Julie's professional goals 
ttinuation of research, teaching, and clinical experiences 
g children and their families. 












fa